narcotics @ er for well known patients

[massiverga]

I am in the middle of a nightmare. My wife on strong narcotics for the better part of this last twenty years, was dropped by her doc because there was a reduction in his schedule. Anyway he prescribe a month worth of her meds. We couldn't get an approved doc in an approved insurance with the approval for pain meds.  We go the E.R. ,Try City in Vista /Oceanside. New policy ! no narcotics for patients of the ER. My wife has been going there for eight years, but "no we don't know you and the new policy states....."  They won't give her anything remotedly close to what she used to, I can in some way live with that but she was sent home with a prescription that lasted two days. Pain 's back, ambulance ,ER same results. She had a Whipple procedure fifteen years ago ,after the docs found pancreatic cancer.  the pain shoots from upper gastric left side to back. It's very sharp and once the pain persist ittrigger vomit and diarreah. and then at last sometimes an epileptic attack . you see why I need qan experienced phisichian  that get thing done.  sorry for my spelling, but I am under so much stress, because the wellbeing of a very sic wife is in my hands.

[Tuckamore]

I think many chronic pain patients have a bit of a "reserve" - because we are all frightened to death of losing our PMP. Sadly these days there doesn't have to be a warning or even a good reason. Actually I was told something similar by a PMP.

It's very difficult to find a physician that truly cares about his/her patients. That statement includes non-chronic pain patients also. I think OB/GYN have a lot of passion and caring for their patients and babies. Granted there are the few in all specialties that do care - but they are harder and harder to find. Health Care has become a business.

~Tuck  

[mariepi]

That is why I kind of hoard my meds over time. It did happened to me 10 years ago. My dr. died and no one took his practice, he was the one who told me when I started pain medication  to save some for bad days in case of... .I was left in the cold . I managed to find a new PCP at the last minute. Now I have a reserve of few months. My husband and one of my kids know where  it is and what to do in case of emergency, lets say if I die. I don't mind what the medical world says about it, is my life, and if they don't give a dam about me ...well....I have to protect myself.
I always hate taking pain pills but it gave me back my life, almost, I can function but the politicians if they are not stoned don't see our point of view.

[Tuckamore]

You're right Feral about contacting their insurance caseworker. Good thought!

Urgent Care usually won't prescribe, at least more than a very few tablets.  
In fact Every Clinic and Urgent Care I've been to (I take ppl to their appts) in this state has a sign that says, "We do not prescribe Narcotics. Don't ask." That's my state, others may be different. Anything is worth a try at this point!!

~Tuck

[FeralFeline]

Do you have an Urgent Care that's not attached to a hospital? I'm not sure how it is where you're at, but most urgent care facilities are running Dr's offices in the day & after 5-6pm are urgent care. You can try going in as a walk in during daytime hours. Your other alternative is to contact your wife's insurance caseworker & ask for advice. Lastly, check the network providers & call everyone in pain management & see where you can get your wife in the soonest. Unfortunately, their appointments are usually a month or more out! However, in the meantime you could take her to an acupuncturist, but she'll probably go through withdrawals since she's been on pain meds for so long.

Hope this helps. Stay strong!

[Tuckamore]

Hi and Welcome to the Pain Management Forum.

My heart aches for your wife and this horrid situation. I wish I had happy, helpful news. I don't. So bear with me as my suggestions and questions may sound a bit out there - but there's no easy answers today.

Did her last PMP not refer her or recommend another PMP? He certainly should have, but than nothing surprises me in PM (pain management.) Did she consult her PCP (primary care physician) for a referral to another PMP? If not I think she really needs to do that.

I've had to go outside my insurance to see a PMP. Yes I had to pay out of pocket but sometimes there are no other choices. If you can find a PMP that will treat your wife you may just have to pay as I did. Usually they "adjust" their charges based on no insurance coverage.

I doubt going to another ER in the area will help. When one ER makes a policy such as you described then all the area ones make the same or very similar policy. If everyone isn't seeing this in their ERs (ED) I believe this policy or a similar one will soon be through out the US. Sad!! Sad!! Sad!!

Do I understand correctly? She had pancreatic cancer 15 years ago? She is cancer free at this time?

Her PCP, surgeons or whoever is following her medically need to get involved in her PM. They may be unable to RX opiates but they are able to refer, discuss and document well her reasons for pain. She may even have to see surgeons, etc that cannot help her at this point but can document her reasons for severe pain.

If I understand your post, she has such pain that it induces vomiting, diarrhea and seizures? Is this documented some where? You need that documentation. IF she has a seizure call an ambulance asap. ER (ED)
may not have to provide opiates but they should treat the seizures. If she is ill enough they may admit her.

As you know it's Memorial Day. I assume her PCP and supporting medical physicians are off for the day. Unless she becomes very ill (not pain wise) I see no choices for today.

Get on the phone as soon as her PCP office is open... indeed you might just want to take her in - yes without an appointment - and yell HELP!!! You need to get someone's attention. I assume she looks pretty tough and you want them to see her.

Today you might want to call your pharmacist for suggestions for OTC meds that may at least help her relax or rest like an antihistamine. But don't take anything without speaking to a pharmacist. It may interact with other meds she is taking.

I wish I had better suggestions.... indeed I wish there were other options. Is your wife a senior citizen or on disability? There are agencies for both categories that may be of assistance.

I am so very sorry that PM patients are treated with such disregard, it's a national shame rather the lawmakers recognize it or not. We don't treat our beloved pets with such cruelty. The Humane Society and similar agencies would beat down your door if you had an animal that was ill and in severe pain that wasn't being treated!! Sad that we treat humans worse than animals. Sorry, the climate in pain management upsets me to no end!

Please feel free to ask additional questions. And Please let us know how you and your wife are doing. I know this is very difficult for her and it must be very difficult for you too. She is blessed to have your support. I'll look forward to hearing from you soon.

Best of Luck,
~Tuck

[Jjewelz1987]

That's absolutely rediculous.  I'd try going to other hospitals ER in the area and see if they carry the same policy.  Another hospital is bound to help her. The medical community truely makes me sick!!!!

Hang in there and god bless